EP1053762A2 - Electrode munie d'un terminal permettant son introduction sous le cuir chevelu et d'une gaine jetable - Google Patents

Electrode munie d'un terminal permettant son introduction sous le cuir chevelu et d'une gaine jetable Download PDF

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Publication number
EP1053762A2
EP1053762A2 EP00304160A EP00304160A EP1053762A2 EP 1053762 A2 EP1053762 A2 EP 1053762A2 EP 00304160 A EP00304160 A EP 00304160A EP 00304160 A EP00304160 A EP 00304160A EP 1053762 A2 EP1053762 A2 EP 1053762A2
Authority
EP
European Patent Office
Prior art keywords
sheath
terminal
lead
electrode
tissue
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP00304160A
Other languages
German (de)
English (en)
Other versions
EP1053762B1 (fr
EP1053762A3 (fr
Inventor
Paul Gibbons
Timothy Beardsley
Terrence Young
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Codman and Shurtleff Inc
Original Assignee
Codman and Shurtleff Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Codman and Shurtleff Inc filed Critical Codman and Shurtleff Inc
Publication of EP1053762A2 publication Critical patent/EP1053762A2/fr
Publication of EP1053762A3 publication Critical patent/EP1053762A3/fr
Application granted granted Critical
Publication of EP1053762B1 publication Critical patent/EP1053762B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0526—Head electrodes
    • A61N1/0529—Electrodes for brain stimulation

Definitions

  • the invention relates generally to implantable medical devices, and more particularly, to systems having an implantable device coupled to an electrical lead for being tunneled through tissue to allow a connection to a mating terminal.
  • Implantable medical devices are used in a variety of applications.
  • One such medical application includes the monitoring of electrical impulses on the surface of a patient's brain. Tracking electrical activity of the brain is useful in conjunction with the treatment and/or diagnosis of certain medical conditions, such as epilepsy.
  • Exemplary electrodes for contacting the brain are disclosed in U.S. Patent Nos. 4,903,702 and 5,044,368, which are incorporated herein by reference.
  • electrodes are implanted within the cranium in contact with the patient's brain.
  • the surgeon typically forms a hole in the patient's skull for accessing selected tissue.
  • One or more electrodes are positioned on the patient's brain for monitoring its electrical activity. After the electrodes are placed at the desired location, they must be coupled to a remote monitoring device which analyzes the data from the probes.
  • a lead extends from the electrode to provide a signal pathway to the remote monitoring device.
  • a trocar is tunneled under the patient's scalp for a predetermined distance after which it exits the scalp.
  • the terminal end of the electrode lead is then threaded through a passageway in the trocar so that the terminal can be connected to a corresponding mating terminal of a lead coupled to the remote monitoring device.
  • the exposed terminal of the electrode lead becomes covered with bodily tissue and fluid as it passes through the trocar. Exposure to bodily substances can impair the integrity of an electrical connection between the terminal end of the eleectrode lead and the mating terminal of the remote device lead, which provides a signal path to the remote monitoring device. Due to the relatively high level of sensitivity that is required for accurate detection of signals generated by the brain, any attenuation or interference with the signals from the electrode can render the resulting data useless and/or misleading.
  • the present invention provides a system including a fluid impermeable sheath disposed on a lead terminal for preventing bodily fluids from contacting the terminal.
  • a fluid impermeable sheath disposed on a lead terminal for preventing bodily fluids from contacting the terminal.
  • the system is primarily shown and described in conjunction with a lead extending from an electrode for intracranial implantation, it is understood that the invention has other applications as well.
  • the electrode can be implanted at other locations in the body, such as in or near, the heart, the intestines and the extremities.
  • the system includes an electrode adapted for implantation in the patient's body, such as on the surface of a patient's brain.
  • a lead has a first end coupled to the electrode and a second end that provides an electrical terminal.
  • a fluid impermeable sheath is disposed on the terminal for preventing bodily fluids and tissues from contacting the terminal. The sheath forms a barrier for maintaining the terminal in pristine condition while the lead terminal is tunneled under the patient's scalp and until it ultimately exits the scalp when it can be electrically connected with a mating terminal.
  • the mating terminal can provide a signal path to a remote device for monitoring signals from the electrode and/or electrical stimulation of tissue.
  • the sheath is removably engaged with the lead so as to cover the terminal.
  • the sheath is at least semi-rigid with a distal end having an edge to facilitate tunneling of the lead under the scalp.
  • the sheath is a flexible and can be torn away from the terminal after the lead has been tunneled through tissue.
  • the sheath is formed from a polymeric material which can be shrink-fitted onto the terminal.
  • FIGS. 1-3 show a system 100 in accordance with the present invention that is partially implantable within a patient's cranium 10.
  • the system 100 includes an implantable electrode 102 adapted for placement on a surface of the patient's brain 12.
  • the electrode 102 detects electrical signals from the brain 12 and conveys these signals to a remote monitoring device (not shown). It is understood that the electrode can also deliver electrical signals to the brain.
  • the electrode 102 is placed in contact with the brain 12 via an aperture 14 formed in the patient's skull 16 and scalp 18.
  • a lead 104 has a first end 106 coupled to the electrode 102 and a second end 108 which provides an electrical terminal 110.
  • the terminal 110 is covered by a fluid impermeable sheath 112 for preventing bodily tissue from contacting the terminal 110.
  • a surgeon tunnels the lead terminal 110 under the patient's scalp 18 (FIG. 2). While tunneling the lead terminal 110 under the scalp, the sheath 112 forms a barrier between bodily substances and the lead terminal 110. After tunneling under the scalp 18 for a desired distance, the lead terminal 110 exits the scalp (FIG. 3) to allow the terminal to be connected to a corresponding mating terminal (not shown).
  • the sheath 112 obviates the need for a trocar when tunneling a lead terminal under the scalp. More particularly, in a conventional technique a trocar is tunneled under the patient's scalp after which the uncovered lead terminal is threaded through a passageway in the trocar. In contrast to the sheath 112, a trocar provides little, if any, protection against exposure of a lead terminal to bodily fluids and the like.
  • the lead terminal 110 can have various structures and geometries depending upon, for example, the intended application.
  • the lead terminal 110 can be elongate, round, cylindrical, triangular, and polygonal.
  • the lead terminal is cylindrical.
  • FIGS. 4-5 show further details of the terminal/sheath assembly 110,112.
  • the lead terminal 110 has a series of contacts in the form of rings 114a-n spaced by insulative sections 116a-n.
  • Each of the rings 114 is connected to a corresponding electrical contact disposed on the implantable electrode 102 (FIG. 1) via a respective conductor (not shown) within the lead 104.
  • the rings 114 provide corresponding signal paths to a female mating conductor for enabling propagation of the signals to (and from) a remote device (not shown).
  • the terminal 110 has a distal end 118 and a proximal end or base portion 120.
  • the base portion 120 can have a variety of engagement mechanisms for coupling the lead 104 to the sheath 112. Exemplary engagement mechanisms include threads, surface features, interference fits, and adhesive bonds.
  • the base portion 120 has threads 122 disposed thereon for engaging complementary threads 124 disposed on a proximal end 126 of the sheath. It is understood that threaded engagement of the sheath 112 to the terminal 110 forms a substantially fluid impermeable seal against bodily fluids and the like.
  • the sheath 112 has a structure for receiving and covering the lead terminal 110 such that the terminal contacts 114 remain uncontaminated by any bodily substance. Maintaining the terminal 110, and therefore the ring contacts 114, in a pristine state optimizes the conditions for achieving a reliable electrical connection between the contacts and corresponding electrical contacts on the mating connector (not shown). It is understood that the integrity of the signal from the implanted electrode 102 to a remote monitoring device must be maintained for meaningful analysis of the electrical activity of the brain. And while it may be possible to clean a soiled terminal, some residual tissue and/or cleaning solution can increase the likelihood of a defective or intermittent electrical connection.
  • the sheath 112 can have a variety of characteristics and structural features based upon the geometry of the lead terminal 110 and the requirements of a particular application.
  • the sheath 112 can vary from extremely rigid to extremely flexible.
  • the geometry of the sheath can be cylindrical, polygonal, smooth, contoured, and surface featured. In general, the sheath 112 is adapted to surround and cover the lead terminal 110.
  • the sheath 112 is rigid and generally cylindrical with a distal end 128 and a proximal end 126.
  • a bore 132 extends from the proximal end 126 of the sheath to a point near the distal end 128.
  • the bore 132 is sized to capture the terminal 110 as the sheath 112 is coupled to the lead 104. Threads 124 on the proximal end 126 of the bore 132 engage the threads 122 on the base 120 of the terminal 110.
  • the distal end 128 of the rigid sheath 112 has an edge 134 to facilitate tunneling of the terminal 110 under the patient's scalp.
  • the edge 134 tapers.
  • the distal end 128 of the sheath converges to a point.
  • FIG. 6 shows an alternative embodiment of the sheath/terminal engagement mechanism.
  • the base portion 120' of the terminal 110' includes a raised surface feature 136.
  • the sheath 112' has a corresponding depression 138 to provide a longitudinal snap-fit engagement.
  • FIG. 7 shows a further embodiment of a sheath 200 for protecting a terminal 202 from bodily substances.
  • the sheath 200 has first and second portions 204a,b that snap together to surround the terminal 202.
  • each of the sheath portions 204a,b has complementary surface features 206, e.g., protrusions and apertures, for retaining the portions together.
  • Channels 208a,b formed in the sheath portions 204a,b are sized to receive the elongate lead terminal.
  • a bump 210 on the base of the terminal 202 and corresponding depressions 212a,b within the channels 208a,b are effective to align the terminal 202 within the sheath portions 204a,b.
  • the sheath portions 204 can be separated and disposed of.
  • the rigidity of the sheath can be varied.
  • Exemplary materials for a rigid sheath include polyethylene, polycarbonate, polypropylene, polyurethane, Nylon, Kynar, polyvinyl chloride, and acrylonitrile-butadiene-styrene copolymer (ABS).
  • ABS acrylonitrile-butadiene-styrene copolymer
  • an edge or point can be formed from a separate component joined to the body of the sheath.
  • the edge or point can be formed from steels or other such materials for cutting and/or tunneling which are known to one of ordinary skill in the art.
  • the overall dimensions of the sheath can vary to optimize the device for a particular application.
  • the length of the sheath can vary from about one centimeter to about ten centimeters and the diameter of the sheath can vary from about two millimeters to about ten millimeters.
  • FIG. 8 shows a lead terminal 300 covered by a flexible, fluid-impermeable sheath 302.
  • the sheath 302 can be formed from a material that can be shrunken to fit snugly over the lead terminal 300.
  • the terminal 300 is inserted into a relatively loose-fitting sheath 302 and subjected to heat which shrinks the sheath such that it conforms to the outer surface of the terminal 300.
  • the sheath is initially rolled up.
  • the sheath is positioned at the distal end of the terminal and unrolled such that the lead terminal is covered by the sheath.
  • the sheath After use, e.g., after the lead is tunneled under the patient's scalp, the sheath is easily removed from the terminal by tearing it or otherwise disposing of the sheath. Thus, the sheath is disposable while the lead may be re-used.
  • the thickness of the sheath 202 can vary to achieve a suitable fluid-impermeable barrier for the terminal.
  • An exemplary thickness for the sheath ranges from about 0.1 millimeters to about 2.0 millimeters.
  • the flexible sheath 202 can be formed from a variety of materials having suitable properties. Exemplary materials include silicone, latex, polyvinyl chloride, Kraton, rubber, and low density polyethylene (LDPE).
  • exemplary materials include silicone, latex, polyvinyl chloride, Kraton, rubber, and low density polyethylene (LDPE).

Landscapes

  • Health & Medical Sciences (AREA)
  • Neurology (AREA)
  • Neurosurgery (AREA)
  • Psychology (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Electrotherapy Devices (AREA)
EP00304160A 1999-05-18 2000-05-17 Electrode munie d'un terminal permettant son introduction sous le cuir chevelu et d'une gaine jetable Expired - Lifetime EP1053762B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/313,827 US6324414B1 (en) 1999-05-18 1999-05-18 Tunneling lead terminal having a disposal sheath
US313827 1999-05-18

Publications (3)

Publication Number Publication Date
EP1053762A2 true EP1053762A2 (fr) 2000-11-22
EP1053762A3 EP1053762A3 (fr) 2002-10-09
EP1053762B1 EP1053762B1 (fr) 2005-08-31

Family

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EP00304160A Expired - Lifetime EP1053762B1 (fr) 1999-05-18 2000-05-17 Electrode munie d'un terminal permettant son introduction sous le cuir chevelu et d'une gaine jetable

Country Status (4)

Country Link
US (1) US6324414B1 (fr)
EP (1) EP1053762B1 (fr)
JP (1) JP4926315B2 (fr)
DE (1) DE60022258T2 (fr)

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004038758A2 (fr) * 2002-07-19 2004-05-06 Arizona Board Of Regents Acting For And On Behalf Of Arizona State University Etage de tete integre souple destine a une interface neuronale
US7018384B2 (en) 2002-08-29 2006-03-28 Medtronic, Inc. Medical passing device and method
US7983765B1 (en) * 2005-08-19 2011-07-19 Pacesetter, Inc. Left chamber pressure sensor lead delivery system
US10449355B2 (en) 2012-06-13 2019-10-22 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine and kits for implanting the same
US11331488B2 (en) 2007-03-09 2022-05-17 Mainstay Medical Limited Systems and methods for enhancing function of spine stabilization muscles associated with a spine surgery intervention
US11406421B2 (en) 2016-07-05 2022-08-09 Mainstay Medical Limited Systems and methods for enhanced implantation of electrode leads between tissue layers
US11471670B2 (en) 2010-03-11 2022-10-18 Mainstay Medical Limited Electrical stimulator for treatment of back pain and methods of use
US11679262B2 (en) 2007-03-09 2023-06-20 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine
US11679261B2 (en) 2007-03-09 2023-06-20 Mainstay Medical Limited Systems and methods for enhancing function of spine stabilization muscles associated with a spine surgery intervention
US11684774B2 (en) 2010-03-11 2023-06-27 Mainstay Medical Limited Electrical stimulator for treatment of back pain and methods of use
US11786725B2 (en) 2012-06-13 2023-10-17 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine and kits for implanting the same
US11951310B2 (en) 2007-03-09 2024-04-09 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine

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US8409233B1 (en) 1999-11-19 2013-04-02 Boston Scientific Neuromodulation Combined subcutaneous tunneler and carrier
US6605094B1 (en) * 1999-11-19 2003-08-12 Advanced Bionics Corporation Integrated subcutaneous tunneling and carrying tool
US20030065373A1 (en) * 2001-10-02 2003-04-03 Lovett Eric G. Medical device having rheometric materials and method therefor
US7072703B2 (en) 2002-12-31 2006-07-04 Cardiac Pacemakers, Inc. Medical device with force monitoring features and method therefor
US7218970B2 (en) * 2003-06-20 2007-05-15 Cardiac Pacemakers, Inc. System for medical lead tunneling
US7655014B2 (en) 2004-12-06 2010-02-02 Cameron Health, Inc. Apparatus and method for subcutaneous electrode insertion
US8718793B2 (en) * 2006-08-01 2014-05-06 Cameron Health, Inc. Electrode insertion tools, lead assemblies, kits and methods for placement of cardiac device electrodes
US7848822B2 (en) * 2006-11-14 2010-12-07 Cardiac Pacemakers, Inc. Cardiac force sensor and methods of use
EP2131908A2 (fr) * 2007-02-28 2009-12-16 Medtronic, Inc. Système de dispositif médical implantable à élément de fixation
EP2550991B1 (fr) 2007-03-09 2020-09-02 Mainstay Medical Limited Système de stimulation électrique neuromusculaire
US10925637B2 (en) 2010-03-11 2021-02-23 Mainstay Medical Limited Methods of implanting electrode leads for use with implantable neuromuscular electrical stimulator
CN101980666A (zh) * 2008-03-18 2011-02-23 湖区制造公司 皮下开通道装置
US8852206B2 (en) 2008-06-12 2014-10-07 The Regents Of The University Of Michigan Probe insertion device for implanting a probe into tissue
US20100030230A1 (en) * 2008-07-31 2010-02-04 Medtronic, Inc. Medical device system and apparatus for guiding the placement of a subcutaneous device
US9999763B2 (en) 2012-06-13 2018-06-19 Mainstay Medical Limited Apparatus and methods for anchoring electrode leads adjacent to nervous tissue
US10195419B2 (en) 2012-06-13 2019-02-05 Mainstay Medical Limited Electrode leads for use with implantable neuromuscular electrical stimulator
US9186501B2 (en) 2012-06-13 2015-11-17 Mainstay Medical Limited Systems and methods for implanting electrode leads for use with implantable neuromuscular electrical stimulator
US9220913B2 (en) 2013-05-06 2015-12-29 Medtronics, Inc. Multi-mode implantable medical device
US10556117B2 (en) 2013-05-06 2020-02-11 Medtronic, Inc. Implantable cardioverter-defibrillator (ICD) system including substernal pacing lead
US9717898B2 (en) 2013-05-06 2017-08-01 Medtronic, Inc. Systems and methods for implanting a medical electrical lead
US10668270B2 (en) 2013-05-06 2020-06-02 Medtronic, Inc. Substernal leadless electrical stimulation system
US20140330287A1 (en) 2013-05-06 2014-11-06 Medtronic, Inc. Devices and techniques for anchoring an implantable medical device
US10471267B2 (en) 2013-05-06 2019-11-12 Medtronic, Inc. Implantable cardioverter-defibrillator (ICD) system including substernal lead
US9717923B2 (en) 2013-05-06 2017-08-01 Medtronic, Inc. Implantable medical device system having implantable cardioverter-defibrillator (ICD) system and substernal leadless pacing device
US10434307B2 (en) 2013-10-15 2019-10-08 Medtronic, Inc. Methods and devices for subcutaneous lead implantation
US10792490B2 (en) 2013-11-12 2020-10-06 Medtronic, Inc. Open channel implant tools and implant techniques utilizing such tools
US9610436B2 (en) 2013-11-12 2017-04-04 Medtronic, Inc. Implant tools with attachment feature and multi-positional sheath and implant techniques utilizing such tools
US10743960B2 (en) 2014-09-04 2020-08-18 AtaCor Medical, Inc. Cardiac arrhythmia treatment devices and delivery
US10328268B2 (en) 2014-09-04 2019-06-25 AtaCor Medical, Inc. Cardiac pacing
US9636505B2 (en) 2014-11-24 2017-05-02 AtaCor Medical, Inc. Cardiac pacing sensing and control
EP3188793B1 (fr) 2014-09-04 2020-01-01 Atacor Medical, Inc. Élément de réception pour fil conducteur de stimulateur cardiaque
US10471268B2 (en) 2014-10-16 2019-11-12 Mainstay Medical Limited Systems and methods for monitoring muscle rehabilitation
US9636512B2 (en) 2014-11-05 2017-05-02 Medtronic, Inc. Implantable cardioverter-defibrillator (ICD) system having multiple common polarity extravascular defibrillation electrodes
US11097109B2 (en) 2014-11-24 2021-08-24 AtaCor Medical, Inc. Cardiac pacing sensing and control
US11083491B2 (en) 2014-12-09 2021-08-10 Medtronic, Inc. Extravascular implant tools utilizing a bore-in mechanism and implant techniques using such tools
US10349978B2 (en) 2014-12-18 2019-07-16 Medtronic, Inc. Open channel implant tool with additional lumen and implant techniques utilizing such tools
US10729456B2 (en) 2014-12-18 2020-08-04 Medtronic, Inc. Systems and methods for deploying an implantable medical electrical lead
US10786668B2 (en) 2016-09-13 2020-09-29 Cardiac Pacemakers Inc. Protective sheath and method for protecting a lead during implant and pulse generator replacement
US11672975B2 (en) 2019-05-29 2023-06-13 AtaCor Medical, Inc. Implantable electrical leads and associated delivery systems
US11666771B2 (en) 2020-05-29 2023-06-06 AtaCor Medical, Inc. Implantable electrical leads and associated delivery systems

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Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004038758A2 (fr) * 2002-07-19 2004-05-06 Arizona Board Of Regents Acting For And On Behalf Of Arizona State University Etage de tete integre souple destine a une interface neuronale
WO2004038758A3 (fr) * 2002-07-19 2004-07-15 Univ Arizona Etage de tete integre souple destine a une interface neuronale
US7018384B2 (en) 2002-08-29 2006-03-28 Medtronic, Inc. Medical passing device and method
US7983765B1 (en) * 2005-08-19 2011-07-19 Pacesetter, Inc. Left chamber pressure sensor lead delivery system
US11679261B2 (en) 2007-03-09 2023-06-20 Mainstay Medical Limited Systems and methods for enhancing function of spine stabilization muscles associated with a spine surgery intervention
US11331488B2 (en) 2007-03-09 2022-05-17 Mainstay Medical Limited Systems and methods for enhancing function of spine stabilization muscles associated with a spine surgery intervention
US11679262B2 (en) 2007-03-09 2023-06-20 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine
US11951310B2 (en) 2007-03-09 2024-04-09 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine
US11471670B2 (en) 2010-03-11 2022-10-18 Mainstay Medical Limited Electrical stimulator for treatment of back pain and methods of use
US11684774B2 (en) 2010-03-11 2023-06-27 Mainstay Medical Limited Electrical stimulator for treatment of back pain and methods of use
US10449355B2 (en) 2012-06-13 2019-10-22 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine and kits for implanting the same
US11786725B2 (en) 2012-06-13 2023-10-17 Mainstay Medical Limited Systems and methods for restoring muscle function to the lumbar spine and kits for implanting the same
US11406421B2 (en) 2016-07-05 2022-08-09 Mainstay Medical Limited Systems and methods for enhanced implantation of electrode leads between tissue layers
US11937847B2 (en) 2016-07-05 2024-03-26 Mainstay Medical Limited Systems and methods for enhanced implantation of electrode leads between tissue layers

Also Published As

Publication number Publication date
DE60022258T2 (de) 2006-05-18
JP4926315B2 (ja) 2012-05-09
US6324414B1 (en) 2001-11-27
EP1053762B1 (fr) 2005-08-31
EP1053762A3 (fr) 2002-10-09
JP2000354587A (ja) 2000-12-26
DE60022258D1 (de) 2005-10-06

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